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ADIRA (Anti-inflammatory Diet In Rheumatoid Arthritis)

Not Applicable
Completed
Conditions
Rheumatoid Arthritis
Interventions
Other: Protein diet
Other: Fiber diet
Registration Number
NCT02941055
Lead Sponsor
Göteborg University
Brief Summary

Rheumatoid arthritis (RA) is a chronic inflammatory disease that affects 0.5-1% of the population, and where many patients in spite of modern pharmacological treatment fail to reach remission. The main goal of the randomized cross-over trial ADIRA (Anti-inflammatory Diet In Rheumatoid Arthritis) is to test the hypothesis that a diet intervention will decrease disease activity and improve quality of life in patients with established RA.

Detailed Description

Rheumatoid arthritis (RA) is a chronic inflammatory disease that affects 0.5-1% of the population, and where many patients in spite of modern pharmacological treatment fail to reach remission. This affects physical as well as mental wellbeing and leads to severely reduced quality of life and reduced work capacity, thus yielding high individual as well as societal costs. To optimize treatment, alternatives such as diet should be evaluated as complement to pharmacological treatment. The main goal of the randomized cross-over trial ADIRA (Anti-inflammatory Diet In Rheumatoid Arthritis) is to test the hypothesis that a diet intervention will decrease disease activity and costs and improve quality of life in patients with established RA. In total, 60 RA patients with moderate disease activity will be randomized to receive initially either a portfolio diet based on several food items with suggested anti-inflammatory effects or a control diet (western type), during 2 x 10 wks with a 3 months wash-out between diets. Both groups continue with regular pharmacological treatment. Known food biomarkers will be analyzed to measure intervention compliance. Impact on disease activity (measured by DAS28, a composite score which predicts disability and progression of RA) and quality of life is evaluated after each diet regimen. Metabolomics will be used to evaluate the potential to predict responders to dietary treatment. ADIRA will provide evidence whether dietary treatment of RA leads to more patients reaching remission and improved quality of life and work capacity as well as reduce individual and societal costs. Scientific evidence exists for anti-inflammatory effect by single foods on RA, but no study exists where these foods have been combined to obtain maximum effect and thus have the potential to offer a substantial improvement in patient life quality. Such evidence has been asked for by RA patents as well as by treating physicians.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
56
Inclusion Criteria
  • Subjects with established RA, disease duration >2 years, disease activity DAS28 >= 2.6 and a disease that is clinically stable and under adequate control and medication, will be invited to participate.
Exclusion Criteria
  • Other life threatening diseases, pregnancy, lactation, food intolerance or allergy to food included in the trial, ability to understand information in Swedish

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
Protein dietProtein diet50% of daily intake, 5 days a week, a diet rich in protein, red meat and saturated fat will be provided to study subjects
Fiber dietFiber diet50% of daily intake, 5 days a week, a diet rich in fiber, fish and probiotics will be provided to study subjects
Primary Outcome Measures
NameTimeMethod
Difference in disease activity score DAS28 (ie a composite score including tender and swollen joints count, ESR or CRP, VAS scale global health) between the two diet interventions, within each person10 weeks of each diet

Measured clinically

Secondary Outcome Measures
NameTimeMethod
Difference in SF-36 between the two diet interventions, within each person10 weeks on each diet

Measured by validated instruments

Differences in inflammatory markers between the two diet interventions, within each person10 weeks on each diet

hs-CRP, cytokines in blood

Difference in EQ5D between the two diet interventions, within each person10 weeks on each diet

Measured by validated instruments

Difference and changes in metabolites between the two diet interventions, within each person10 weeks on each diet

Metabolomics with NMR and MS analyses of serum and urine samples

Difference in HAQ between the two diet interventions, within each person10 weeks on each diet

Measured by validated instruments

Trial Locations

Locations (1)

The University of Gothenburg

🇸🇪

Göteborg, Sweden

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